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Individual

DR. LAURENCE FENN BOURLAND JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1623 SE ENTERPRISE CIR, HILLSBORO, OR 97123-5064
(503) 640-2614
(503) 648-2637
Mailing address
1623 SE ENTERPRISE CIR, HILLSBORO, OR 97123-5064
(503) 640-2614
(503) 648-2637

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 1194
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17032
STATE WORKER COMPENSATION
OR
Enumeration date
03/14/2007
Last updated
09/24/2010
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